Is the devil in the detail? A randomised controlled trial of guided internet-based CBT for perfectionism

Abstract

An internet guided self-help cognitive-behavioural treatment (ICBT) for perfectionism was recently found to be effective (see this issue). Such studies stand in need of replication. The aim of this study was to report the outcomes and predictors of change when the treatment is delivered in a UK setting. A total of 120 people (Mean = 28.9 years; 79% female) were randomised to receive ICBT or wait-list control over 12 weeks (trial registration: NCT02756871). While there were strong similarities between the current study and its Swedish counterpart, there were also important differences in procedural details. There was a significant impact of the intervention on the primary outcome measure (Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale) and also on the Clinical Perfectionism Questionnaire (between group effect sizes d = 0.98 (95% CI: 0.60-1.36) and d = 1.04 (95% CI: 0.66-1.43) respectively using intent-to-treat analyses). Unlike the Swedish study, there was significant non-engagement and non-completion of modules with 71% of participants completing fewer than half the modules. The number of modules completed moderated the rate of change in clinical perfectionism over time. In conclusion, the study indicates the intervention is effective in a UK setting but highlighted the importance of procedural details to optimise retention.

Validation of the clinical perfectionism questionnaire in an eating disorder sample: A bifactor approach

“…Given that perfectionism is posited as a transdiagnostic construct that contributes to the etiology and maintenance of a range of psychological disorders (Egan et al, 2011), future research should also investigate the structure of the CPQ across eating disorder diagnoses and other disorders (e.g., anxiety disorders, depression). Evaluation of measurement invariance of the CPQ across a range of sociodemographic and clinical variables would further inform transdiagnostic theories and the treatment of perfectionism and eating disorders, extending existing findings that indicate the efficacy of cognitivebehavioral therapy for perfectionism (e.g., Shafran et al, 2017). The findings from the present study make an important contribution to the measurement of clinical perfectionism, providing evidence for the construct validity and reliability of the 10-item CPQ in a clinical eating disorder sample.…”

Targeting Procrastination Using Psychological Treatments: A Systematic Review and Meta-Analysis

“…Regrettably, the only case that currently exist reported within- rather than between-group effect sizes (Lloyd et al, 2015), making it impossible to infer any similarities or differences in benefits. Looking more closely at specific examples on the other hand, the between-group effect sizes for ICBT for perfectionism when compared to wait-list control ranges between d of 0.68 to 1.04 (Rozental et al, 2017; Shafran et al, 2017), indicating higher estimates than the overall benefits obtained in the current study.…”

Mental contamination: Relationship with psychopathology and transdiagnostic processes

“…Participants were recruited through university notice boards, online platforms, recruitment websites and social media platforms as part of a wider study to assess the efficacy of an internetbased guided self-help cognitive behavioural therapy intervention for perfectionism (Kothari, Egan, Wade, Andersson, & Shafran, 2016;Shafran et al, 2017). Recruitment therefore targeted populations where perfectionism may be problematic; it therefore included, but was not restricted to, university students.…”